title: Type 2 diabetes and the risk of colorectal adenomas: Black Women's Health Study.
abstract: Evidence for the association of type 2 diabetes mellitus (DM) with colorectal neoplasms is contradictory, and African Americans have been underrepresented in the studies published to date. In a nested case-control study (1995-2009), we examined DM and insulin therapy as risk factors for colorectal adenomas in African American women enrolled in the ongoing Black Women's Health Study. From women reporting ever having undergone a gastrointestinal endoscopy, 917 cases of colorectal adenoma were compared with 2,751 controls without a colorectal polyp, matched on age and follow-up time. Cases were verified by medical record review. We used multivariable logistic regression analyses that included DM exposures and selected confounders. There were no overall associations between DM and adenoma risk or between insulin use and adenoma risk. However, DM without insulin use was inversely associated with risk of colon adenomas (odds ratio (OR) = 0.71, 95% confidence interval (CI): 0.52, 0.97) but not rectal adenomas. DM was inversely associated with adenoma risk in women older than 55 years (OR = 0.64, 95% CI: 0.44, 0.91) but not in women 55 years or younger (OR = 1.24, 95% CI: 0.81, 1.89). Future research should attempt to replicate the unexpected inverse association of DM with colon adenoma risk among older African American women.
authors.forename: Chiranjeev
authors.initials: C
authors.lastname: Dash
authors.forename: Julie R
authors.initials: JR
authors.lastname: Palmer
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Boggs
authors.forename: Lynn
authors.initials: L
authors.lastname: Rosenberg
authors.forename: Lucile L
authors.initials: LL
authors.lastname: Adams-Campbell
mesh_terms: D000236:Adenoma / Q000188:drug therapy / Q000208:ethnology*; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000208:ethnology; D015992:Body Mass Index; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000208:ethnology*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000208:ethnology*; D004032:Diet; D004522:Educational Status; D015444:Exercise; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D007417:Intestinal Polyps / Q000208:ethnology; D008875:Middle Aged; D012307:Risk Factors; D016387:Women's Health
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin
keywords: African American women; colorectal adenoma; colorectal cancer; diabetes; insulin